Provider Demographics
NPI:1225308000
Name:THOMAS, JULIET NICOLE (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:NICOLE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 DAYTON BLVD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-4626
Mailing Address - Country:US
Mailing Address - Phone:423-682-8402
Mailing Address - Fax:423-682-8403
Practice Address - Street 1:3421 DAYTON BLVD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-4626
Practice Address - Country:US
Practice Address - Phone:423-682-8402
Practice Address - Fax:423-682-8403
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3838101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional